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HomeMy WebLinkAbout20180522 Koser Miller.pdf18052201 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KC Wisconsin Motor Vehicle Crash Report Secondary CrashAmendedCrash Type Private Property/Parking LotReportable TagsSchool Bus Related Yes, school bus directly inActive School ZoneGovernment Property Trailer or TowedWork ZoneLane ClosureHit and RunOn Emergency Total Killed 00 Total Injured 00 Total Units 02 Time Notified 08:21 AM Date Notified 05/22/2018 Time Arrived 08:26 AM Date Arrived 05/22/2018 Crash Time 08:20 AM Crash Date 05/22/2018 Investigating Officer/Deputy DEPUTY AMANDA REED Agency Crash NumberPrimary Crash Document #Document Number Override 6V L 1 3 J 5 5 K C Additional InformationPhotos Photos ByDEPUTY AMANDA REED Reconstruction ByDiagram Description Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. ON MAY 22ND, I, DEPUTY REED RESPONDED TO A BUS VS CAR ACCIDENT AT THE HAYWARD INTERMEDIATE SCHOOL IN THE BUS DROP OFF ZONE ON SCHOOL PROPERTY. THE SCHOOL BUS DRIVER WAS ATTEMPTING TO NEGOTIATE A CORNER AND ACCIDENTLY SIDE SWIPED A VEHICLE THAT WAS NOT SUPPOSE TO BE PARKED IN THE LOADING UNLOADING ZONE. PHOTOS TAKEN OFF ACCIDENT. Crash Time 08:20 AM Crash Date 05/22/2018Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. 18052201 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KC Wisconsin Motor Vehicle Crash Report Structure Type House/Building Y Coordinate 5105525.5 X Coordinate 152377.578125 Longitude -91.490744899 Latitude 46.014996368 PRIVATE PROPERTY 15930 FIFTH ST (HOUSE/BUILDING 15930) IN THE CITY OF HAYWARDIN SAWYER COUNTY Location Special StudyAccess Control No Control Tribal Land Crash Classification - Jurisdiction Private Property Crash Classification - Location Private Property Relation To Trafficway Non Trafficway - Other Animal Type Weather Condition(s) Environment Factor(s) None Roadway Factor(s) None Road Surface Condition(s) Dry Light Condition Daylight Manner of Collision 05--Sideswipe/Same Direction First Harmful Event Location In Parking Lane or Zone First Harmful Event Motor Veh In Transport Crash Scene Intersection Type Not an Intersection Junction Location Non-Junction Within Interchange Area NO Reporting Threshold No Truck Bus or HazMat Any vehicle designed to carry 9 or more ppl, including driver Road Grade Level Road Curvature Curve Left Surface Type Blacktop (Bituminous) Traffic Control Inoperative/Missing NO Traffic Control No Control Traffic Way Parking Lot or Private Property Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With Parked Motor Vehicle Total Lanes 0 Speed Limit 15Pre CrashTire Mark Direction Of Travel Not On Roadway Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # Injured 0 Total Occs 1 Operating As Endorsements S - SCHOOL BUS Vehicle Type School Bus Unit Type Bus Vehicle Operating As Classification C CLASS Unit Status In Transit UN I T 01 Unit Summary Extent Of Damage Minor Damage Vehicle Damage 5--Right Rear Corner Initial Contact Point 5--Right Rear Corner Bus UseSchoolBody Style BU - BUS Color YEL - Yellow Model 1 DOOR BUS Year 2007 Make I C CORPORATION Vehicle Identification Number 14 Country of Issuance UNITED STATES St WI Plate Type BUS - Bus License Plate Number 3256B VE H I C L E UN I T 01 Vehicle Crash Time 08:20 AM Crash Date 05/22/2018Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. 18052201 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KC Wisconsin Motor Vehicle Crash Report Driver DistractionsNot Distracted Driver Actions Other Contributing Action Driver Prior Action Other Vehicle Factors Not Applicable What Driver Was Doing Negotiating Curve Vehicle Removed By OPERATOR Towed Due To Damage Not Towed VE H I C L E UN I T 01 Address HAYWARD, WI 54843 , US Organization/CompanyHURRICANE BUSING INC01 VE H I C L E OW N E R Vehicle Owner Sequence Of Events EventMotor Veh In Transport01 EventParked Motor Vehicle02 Event 03 Event 04 Organization/Company HURRICANE BUSING INC Insurance Company PEERLESS-INS-CO Policy Holder UN I T Crash Time 08:20 AM Crash Date 05/22/2018Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. 18052201 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KC Wisconsin Motor Vehicle Crash Report Individual Condition Appeared Normal Drug Type Drug Test ResultsDrug Test TypeDrug Test GivenTest Not Given Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given Test Not Given Suspected Drug UseSuspected Alcohol Use Action Other IN D I V I D U A L UN I T Action To/From SchoolLocationPrior ActionStriking Unit # 00 1 01 Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport Not Transported Trapped/Extricated Not Trapped Ejection Path Not Ejected/Not Applicable Ejected Not Ejected Airbag Non Deployed Injury Severity No Apparent Injury IN D I V I D U A L UN I T Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 1--Front Seat-Left Side (Driver/Motorcycle/Bicycl 00 1 Safety Equipment Shoulder & Lap Belt On Duty Crash 01 State: Wisconsin Country: UNITED STATES Address HAYWARD, WI 54843 , US RaceWHITEDate of Birth 11/19/ Sex Male Citations Issued 0 DriverDON P KOSER IN D I V I D U A L UN I T Injury Drug & Alcohol Individual Non Motorist Equipment Address10293 N GREENWOOD LANE HAYWARD, WI 54843 , US NameHURRICANE BUSING INC Source DriverUse Vehicle Owner Same as Carrier 01 Carrier Crash Time 08:20 AM Crash Date 05/22/2018Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. 18052201 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KC Wisconsin Motor Vehicle Crash Report Measured WeightMeasured WidthMeasured LengthMeasured Height Escort Vehicle PresentEscort Vehicle Required By Permit Permitted Vehicle On Permitted Route WI Permit NumberOS/OW Load Permitted LoadCarrier TypeUS DOT # Cargo Body TypeVehicle Configuration GVWR TR U C K B U S UN I T Reporting Threshold No Truck Bus or HazMat No Road Grade Level Road Curvature Curve Left Surface Type Blacktop (Bituminous) Traffic Control Inoperative/Missing NO Traffic Control No Control Traffic Way Parking Lot or Private Property Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With Motor Veh In Transport Total Lanes 0 Speed Limit 15Pre CrashTire Mark Direction Of Travel Not On Roadway Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 0 Operating As EndorsementsVehicle Type Passenger Car Unit Type Automobile Vehicle Operating As Classification D CLASS Unit Status Legally Parked UN I T 02 Unit Summary Driver Distractions Driver Actions No Contributing Action Driver Prior Action Other Vehicle Factors Not Applicable What Driver Was Doing Legally Parked Vehicle Removed By OWNER Towed Due To Damage Not Towed VE H I C L E UN I T 02 Extent Of Damage Functional Damage Vehicle Damage 9--Left Side Middle Initial Contact Point 9--Left Side Middle Bus UseNot A BusBody Style 4D - 4DR Color GRY - Gray Model 6 Year 2008 Make MAZDA Vehicle Identification Number 1 5951 Country of Issuance UNITED STATES St WI Plate Type AUT - Automobile License Plate Number ACN6610 VE H I C L E UN I T 02 Vehicle Crash Time 08:20 AM Crash Date 05/22/2018Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. 18052201 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KC Wisconsin Motor Vehicle Crash Report Not Distracted Address HAYWARD, WI 54843 , US IndividualREANNA M MILLER ( Vehicle Owner Sequence Of Events EventMotor Veh In Transport01 EventParked Motor Vehicle02 Event 03 Event 04 Individual REANNA MILLER Insurance Company GEICO-GENERAL-INS-CO Policy Holder UN I T Crash Time 08:20 AM Crash Date 05/22/2018Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.